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Fixin' Healthcare

Sunday, December 03, 2006

The Lifestyle Chronicles - The Need To Know

My last post expressed a view that some academic health science centers would adjust to changing conditions and design methods to contribute to health care reform. Certainly, these centers have the capability to assist and even lead some aspects of reform. The question is whether they are in a position to do this. Are they part of the solution or part of the problem?

To be sure, health care reform is a complex undertaking that is unlikely to be addressed in a single comprehensive plan. The role of the academic health science centers at this stage is to evaluate the health care system and efforts to change it, design and establish demonstration projects to highlight and clarify high priority issues, and define the important questions and goals for reform.

For example, physicists can design a model that predicts what the universe would look like if several basic conditions such as gravity were changed. What would the health care system and health status look like if every person had health insurance? What other aspects of the nation and the economy would be altered or need to be altered? What is likely to be the impact of Medicare Part D upon health status? What other programs might have contributed more to improved health status? Does the evidence indicate a reasonable probability to eliminate 25% (or even 50%) of acute medical care? Does providing more medical care represent reform? If people are to be made to chose about medical care, could they not chose about behavior to improve health and could these be effectively linked?

I'm sure these specific thoughts are superficial, flawed and/or biased, but the idea of identifying the important questions and providing answers that clarify goals is a viable approach. And, somewhere there has to be a mechanism to collect and formulate what is known into workable policy and bring the public on board. Otherwise, we are left with piecemeal solutions that are molded and promulgated by whichever special interest has the upper hand at the moment.

By the way, West Virginia has launched a medicaid project that bears watching. Lessons learned from other past projects, such as TennCare, need to be retained and added to the equation.

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